视神经脊髓炎的临床特点及MRI诊断分析

目的分析视神经脊髓炎(NMO)的临床特点及MRI诊断价值。方法选取我院收治的37例NMO患者为研究对象,收集患者的性别、年龄、自身免疫性系统性疾病病史、首次发作及复发情况、临床检查及影像资料。结合MRI检查分析NMO的影像学表现及临床特点。结果 37例NMO患者男性、女性患者发病在性别上有显著性差异(P0.05);以眼部症状首发者64.86%显著多于其他首次发作表现患者(P0.05);甲状腺功能异常、正常的患者占比有明显差异(P0.05);脑脊液蛋白定量正常、异常患者占比有明显差异(P0.05)。37例NMO患者脊髓MRI病灶分布颈髓病灶18例(48.65%),胸髓病灶15例(40.54%),颈、胸髓同时受累4例(10.81%);脊髓MRI表现为多于3个椎体节段的连续性长病灶,矢状面扫描脊髓正常粗细或增粗,节段性或弥漫性信号异常,呈T1WI低信号、T2WI高信号,信号均匀或不均匀。37例NMO患者中头部MRI异常29例(78.38%),包括病灶于皮层下及深部脑白质12例、脑室室管膜周围6例、胼胝体4例、丘脑3例、脑桥3例、延髓1例,病灶呈斑片样、点状及类圆形;DWI未见异常强化或不均匀强化,呈等信号或略高信号。结论 NMO患者以眼部症状首发为主,多伴有甲状腺功能异常、脑脊液蛋白定量偏高;脊髓MRI可见颈髓病灶、胸髓病灶受累、头部MRI异常等,MRI对NMO的临床诊断有重要价值。

Analysis of Clinical Characteristics and MRI Diagnosis of Neuro-optic Myelitis

Objective To analyze clinical characteristics and MRI diagnostic value of neuro-optic myelitis (NMO). Methods 37 NMO patients treated in our hospital were selected as the research objects, gender, ages, history of autoimmune systemic disease, first-episode and recurrence, clinical examination and image data of patients were collected. Imaging features and clinical characteristics of NMO were analyzed combined with MRI. Results In 37 NMO patients, there was a significant difference in morbidity in male and female patients (P<0.05), first symptom of eye symptoms 64.86% was significantly more than other first onset performance patients (P<0.05), there was a significant difference in proportion of abnormal thyroid function and normal patients (P<0.05), there was a significant difference in proportion of normal cerebrospinal fluid protein quantity and abnormal patients (P<0.05). In 37 NMO patients, there was 18 cases of medulla spinalis MRI lesion distribution cervical cord lesion (48.65%), 15 cases of thoracic cord lesion (40.54%), cervical and thoracic spinal cord simultaneously in 4 cases (10.81%), medulla spinalis MRI performance were more than 3 vertebral segments continuous long lesion, sagittal scan medulla spinalis normal thickness or thickening, segmental or diffusivity signal abnormity, showed T1WI low signal, T2WI high signal, signal even or uneven. In 37 NMO patients, there was 29 cases of middle head MRI abnormity (78.38%), including 12 cases of lesion subcortex and deep brain white matter, 6 cases of ventricle endyma around, 4 cases of callosum, 3 cases of cerebral ganglia, 3 cases of mesocephalon, 1 case of bulbus medullae, lesions were patchy, punctiform and nearly-circular; DWI did not see abnormal reinforcement or uneven reinforcement, showed equal signal or slightly high signal. Conclusion First symptom of most NMO patients are eye symptoms with abnormal thyroid function and higher cerebrospinal fluid protein quantity;medulla spinalis MRI can see cervical cord lesion, involved thoracic cord lesion, head MRI abnormity, MRI has an important value for clinical diagnosis of NMO.